Restor Dent Endod.  2023 Aug;48(3):e28. 10.5395/rde.2023.48.e28.

Effect of irrigation protocols on smear layer removal, bond strength and nanoleakage of fiber posts using a self-adhesive resin cement

• Alessi RS
• Jitumori RT
• Bittencourt BF
• Gomes GM
• Gomes JC

• KMID: 2548231
• DOI: http://doi.org/10.5395/rde.2023.48.e28

Abstract

Objectives
This study aimed to investigate the effect of the application method of 2% chlorhexidine (CHX) and its influence on the adhesion of fiberglass posts cemented with a self-adhesive resin cement.
Materials and Methods
Sixty human mandibular premolars were endodontically treated and divided into 5 groups (n = 12), according to the canal irrigant and its application method: 2 groups with conventional syringe irrigation (CSI)—2.5% sodium hypochlorite (NaOCl) (control) and 2% CHX— and 3 groups with 2% CHX irrigation/activation—by passive ultrasonic irrigation (PUI), Easy Clean file, and XP-Endo Finisher file. Two roots per group were evaluated for smear layer (SL) removal by scanning electron microscopy. For other roots, fiber posts were luted using a self-adhesive resin cement. The roots were sectioned into 6 slices for push-out bond strength (BS) (7/group) and nanoleakage (NL) (3/group). Data from SL removal were submitted to Kruskal-Wallis and Student-Newman-Keuls tests (α = 0.05). Data from BS and NL were evaluated by 2-way analysis of variance and Tukey’s test (α = 0.05).
Results
For SL removal and BS, the CHX irrigation/activation promoted better values than CSI with CHX (p < 0.05), but it was not significantly different from CSI with NaOCl (p > 0.05). For NL, the lowest values were obtained by the chlorhexidine irrigation/activation groups (p < 0.05).
Conclusions
Active 2% CHX irrigation can be used to improve the post space cleaning and adhesion before fiber post cementation with self-adhesive resin cements.

Keyword

Bond strength; Chlorhexidine; Endodontic fiber posts; Nanoleakage; Root canal irrigants; Self-adhesive luting

Figure

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  Figure 1 Scanning electron microscope micrographs (×2,000) showing: (A) Score 1: no smear layer; (B) Score 2: moderate amount of smear layer; and (C) Score 3: heavy smear layer.

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  Figure 2 Graph showing the failure mode distribution.NaOCl-CSI, 2.5% sodium hypochlorite with conventional syringe irrigation; CHX-CSI, 2% chlorhexidine with conventional syringe irrigation; CHX-PUI, 2% chlorhexidine with activation by passive ultrasonic irrigation; CHX-EC, 2% chlorhexidine with activation by Easy Clean file; CHX-XP, 2% chlorhexidine with activation by XP-Endo Finisher file.

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  Figure 3 Representative scanning electron photomicrographs (original magnification ×60) of post cementation interfaces for each dentinal treatment on middle third of root canal. (A) NaOCl-CSI group. (B) CHX-CSI group. (C) CHX-PUI group. (D) CHX-EC group. (E) CHX-XP group. Arrows indicate silver nitrate infiltrated in the adhesive interface. Interfacial marginal gap formation was significantly reduced in groups CHX-PUI, CHX-EC and CHX-XP compared with NaOCl-CSI (control group) and CHX-CSI.NaOCl-CSI, 2.5% sodium hypochlorite with conventional syringe irrigation; CHX-CSI, 2% chlorhexidine with conventional syringe irrigation; CHX-PUI, 2% chlorhexidine with activation by passive ultrasonic irrigation; CHX-EC, 2% chlorhexidine with activation by Easy Clean file; CHX-XP, 2% chlorhexidine with activation by XP-Endo Finisher file; FP, fiber post; RC, resin cement; RD, root dentin.

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